Christopher Marshall Fuller

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

License

F460-113-89-031-0 Issued in FL

Practice address

5132 Edgeware CT.
Jacksonville, FL 32217

Phone

(904) 874-1761

NPI assigned

Jan 22, 2014

Last updated

Jan 22, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mr. Christopher Marshall Fuller Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1912320334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5132 EDGEWARE CT.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32217",
            "telephone_number": "904-874-1761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5132 EDGEWARE CT.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32217",
            "telephone_number": "904-874-1761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "CHRISTOPHER",
        "middle_name": "MARSHALL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-22",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": "F460-113-89-031-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTOPHER",
            "last_name": "FULLER",
            "middle_name": "MARSHALL",
            "prefix": "MR.",
            "credential": "M.ED",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Full Circle Birth Center
• Full Swing Healthcare LLC
• Full-Out Wellness Healthcare Staffing
• Fuller Rehabilitation and Consulting Services, Inc. (Fuller Rehabilitation)
• Christopher Fuller, PT, DPT
• Erica Fuller, OTR/L
• Julie Fuller, LMT
• Keydella Fuller, APN
• Kimberly J Fuller, NP
• Lisa Fuller

• Developmental Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Developmental Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.